title: Post-stroke case fatality within an incident population in rural Tanzania.
abstract: OBJECTIVE
  To establish post-stroke case fatality rates within a community based incident stroke population in rural Tanzania.
  
  
  METHODS
  Incident stroke cases were identified by the Tanzanian Stroke Incidence Project and followed-up over the next 3-6 years. In order to provide a more complete picture, verbal autopsy (VA) was also used to identify all stroke deaths occurring within the same community and time period, and a date of stroke was identified by interview with a relative or friend.
  
  
  RESULTS
  Over 3 years, the Tanzanian Stroke Incidence Project identified 130 cases of incident stroke, of which 31 (23.8%, 95% CI 16.5 to 31.2) died within 28 days and 78 (60.0%, 95% CI 51.6 to 68.4) within 3 years of incident stroke. Over the same time period, an additional 223 deaths from stroke were identified by VA; 64 (28.7%, 95% CI 20.9 to 36.5) had died within 28 days of stroke and 188 (84.3%, 95% CI 78.1 to 90.6) within 3 years.
  
  
  CONCLUSIONS
  This is the first published study of post-stroke mortality in sub-Saharan Africa from an incident stroke population. The 28 day case fatality rate is at the lower end of rates reported for other low and middle income countries, even when including those identified by VA, although CIs were wide. Three year case fatality rates are notably higher than seen in most developed world studies. Improving post-stroke care may help to reduce stroke case fatality in sub-Saharan Africa.
authors.affiliation: Department of Medicine, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear NE29 8NH, UK. richard.walker@nhct.nhs.uk
authors.forename: Richard W
authors.initials: RW
authors.lastname: Walker
authors.forename: Ahmed
authors.initials: A
authors.lastname: Jusabani
authors.forename: Eric
authors.initials: E
authors.lastname: Aris
authors.forename: William K
authors.initials: WK
authors.lastname: Gray
authors.forename: David
authors.initials: D
authors.lastname: Whiting
authors.forename: Gregory
authors.initials: G
authors.lastname: Kabadi
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Mugusi
authors.forename: Mark
authors.initials: M
authors.lastname: Swai
authors.forename: George
authors.initials: G
authors.lastname: Alberti
authors.forename: Nigel
authors.initials: N
authors.lastname: Unwin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012424:Rural Population; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology / Q000401:mortality*; D016019:Survival Analysis; D013636:Tanzania / Q000453:epidemiology; D014057:Tomography, X-Ray Computed